<form id="adm-mlevels-list-form" enctype="multipart/form-data" method="post" action="" class="form_advanced">
    <div class="adm-mlevels-items">
        <bx_repeat:items>
            <div class="adm-mlevels-item __class__">                
                <input type="checkbox" class="form_input_checkbox" id="adm-mlevels-__id__" name="levels[]" value="__id__" <bx_if:system>disabled="disabled"</bx_if:system> />
                <bx_if:enabled>
                    <a href="__edit_link__">__title__</a>
                    <bx_if:purchasable>
                        <a href="__price_link__"><bx_text:_adm_txt_mlevels_price /></a>
                    </bx_if:purchasable>
                </bx_if:enabled>
                <bx_if:disabled>
                    <label for="adm-mlevels-__id__">__title__</label>
                </bx_if:disabled>
            </div>
        </bx_repeat:items>
    </div>
    __controls__
</form>